Biology-based insight into recurrence risk and radiation benefit after breast-conserving surgery.
For patients and their treating physiciansDCISionRT is the only test capable of predicting an individual patient’s benefit from radiation therapy. Using DCISionRT provides you with 10-year Total and Invasive Recurrence Risk after breast conserving surgery as well as surgery with radiation therapy. No other test can do this.
DCISionRT provides you the information to deliver precision medicine to your patients. Unlike grade, tumor size or patient age, DCISionRT quantifies a woman’s risk based on her DCIS biology. Studies have shown that DCISionRT reclassifies over 50% of patients compared to grade and size[REF CCR]. The future of DCIS management is here with DCISionRT.
DCISionRT has undergone multiple independent validations, including the landmark SweDCIS randomized clinical trial. The test has the highest dynamic range and most consistent results study to study. Evidence includes over 2000 patients from development through validation. No other DCIS test is supported by published Level 1b clinical evidence.
In an independent clinical validation of DCISionRT in the landmark SweDCIS randomized clinical trial, patients with low Decision Scores no significant invasive risk reduction from radiation therapy after surgery whereas patients with elevated Decision Scores had a 9% reduction in invasive risk (HR 0.24, p=0.012). This study, for the first time, demonstrates a DCIS test that predicts the extent to which patients benefit from radiation therapy.
Results are shown are for the 196 patients treated with conserving surgery treated patients with clear margins in a multisite study. Total recurrence risks shown are adjusted for year of diagnosis. This was demonstrated in a multisite study of 474 patients1.
1 Bremer T, Whitworth P, Patel R, et al. . A biologic signature for breast ductal carcinoma in situ to predict radiation therapy (RT) benefit and assess recurrence risk. Clin Cancer Res . 2018; doi:10.1158/1078-0432.CCR-18-0842.
Based on the biology of your DCIS, the DCISionRT test provides you and your physician the information needed to make a decision whether surgery alone or surgery with radiation therapy is appropriate.
DCISionRT provides a woman’s individual DCISionScore on a scale from zero to ten, which corresponds to recurrence risks.
Total risk is the chance of having either a DCIS recurrence or developing invasive breast cancer within 10-years.
Invasive risk is the probability of developing invasive breast cancer in the breast originally diagnosed with DCIS within 10-years.
The Residual Risk Subtype (RRt) is a distinct molecular subtype identified by DCISionRT®. It represents patients with elevated recurrence risk after breast-conserving surgery (BCS) that is driven by the tumor’s underlying biology—not just traditional clinical factors.
DCISionRT generates a continuous Decision Score (0–10).
Different score ranges correspond to biologically distinct subtypes and levels of recurrence risk.
A 9.2 Decision Score indicates:
Importantly, not all elevated scores represent RRt. Many elevated-risk patients derive substantial benefit from radiation and achieve strong risk reduction. RRt specifically identifies a unique group whose tumor biology may warrant broader treatment discussion.
The Residual Risk Subtype enables clinicians to align treatment intensity with tumor behavior, personalize adjuvant therapy recommendations, and support informed, shared decision-making with patients.
The DCISionRT® test indicates your individual risk of recurrence and expected benefit from radiation therapy.
Age: 51 years | DCIS Grade: Intermediate (Grade 2) | DCIS size: 30mm
Risk Assessment
Traditional Clinpath Features
TREATMENT PLAN:
Surgery with radiation therapy
TREATMENT RATIONALE:
Radiation therapy after breast conserving surgery is recommended based on age, grade and size.
Risk Assessment
TREATMENT PLAN:
Breast conserving surgery
TREATMENT RATIONALE:
Because the patient has a Low DCISionRT score, the Physician and patient decide to defer radiation therapy and elect breast conserving surgery.
Age: 45 years | DCIS Grade: Low (Grade 1) | DCIS size: 10mm
Risk Assessment
Traditional Clinpath Features
TREATMENT PLAN:
Breast conserving surgery
TREATMENT RATIONALE:
Traditional risk assessment using clinicopathologic features indicates patient could be considered “low risk” and therefore, the patient and physician elect to forego radiation therapy.
Risk Assessment
TREATMENT PLAN:
Surgery with radiation therapy
TREATMENT RATIONALE:
New information from DCISionRT indicates the patient is at Elevated Risk if treated with surgery alone. The patient and physician decide to use radiation therapy-–despite traditionally low risk clinicopathalogic features—due to the large risk reduction from radiation therapy.
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